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2024, Number 8

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Med Crit 2024; 38 (8)

Rapid diaphragmatic superficial breathing index as a predictor of successful weaning of mechanical ventilation in neurocritical patients

Rodríguez LFA, Rubio PD, Trias BIY, Aguilera RMS

Language: Spanish
References: 40
Page: 650-658
PDF size: 330.72 Kb.


ABSTRACT

Introduction: invasive mechanical ventilation is a vital support for patients with acute respiratory failure in intensive care units. Prolonged use is associated with increased morbidity and mortality. Failure in the weaning process affects 20% of cases, impacting the patient's clinical course and being associated with 50% mortality. Among the various tools and methods for successful weaning, recent applications include the evaluation of diaphragmatic function. Objective: to analyze the association between the diaphragmatic rapid shallow breathing index and the success of the weaning process from mechanical ventilation in neurocritical patients. Material and methods: this is an observational, analytical, cross-sectional, and prospective study conducted on orotracheally intubated neurocritical patients in the Intensive Care Unit. Sample size: data will be analyzed using SPSS. Measures of central tendency and dispersion will be used for quantitative variables, and frequencies and percentages for qualitative variables. The Student's t-test and χ2 or Fisher's test will be applied as appropriate. Kaplan-Meier curves will evaluate differences in evolution and hospital stay. Values of p < 0.05 will be considered significant. Feasibility: the required number of patients is feasible, with sufficient beds and necessary supplies. The researcher has experience in measuring the variables. External funding is not required. Results: a total of 52 patients were included, 42.3% were women and 57.7% men, with a mean age of 37.2 years. The average BMI was 24.4, the mean Glasgow score was 6.8, and they were intubated for an average of 5.2 days. A lower Tobin index (p = 0.003) and reduced leakage percentage (p = 0.000) were associated with greater success in ventilator weaning. Inspiratory tidal volume also showed a positive correlation with success (p = 0.001), as did a lower respiratory rate (p = 0.003). Women had a higher likelihood of success compared to men (p = 0.038). The overall success rate of weaning in the studied population was 90.4%. Conclusions: diaphragmatic Rapid Shallow Index is a predictor of successful ventilator weaning. Factors such as age, respiratory rate, tidal volume, and leakage percentage are predictors of successful ventilator weaning.


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